PD9-04 QUALITY OF LIFE AFTER URINARY DIVERSION WITH ORTHOTOPIC NEOBLADDER

Abstract

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion I1 Apr 2015PD9-04 QUALITY OF LIFE AFTER URINARY DIVERSION WITH ORTHOTOPIC NEOBLADDER Alexander Kretschmer, Tobias Grimm, Alexander Buchner, Birte-Swantje Schneevoigt, Maria Apfelbeck, Markus Grabbert, Christian G. Stief, and Alexander Karl Alexander KretschmerAlexander Kretschmer More articles by this author , Tobias GrimmTobias Grimm More articles by this author , Alexander BuchnerAlexander Buchner More articles by this author , Birte-Swantje SchneevoigtBirte-Swantje Schneevoigt More articles by this author , Maria ApfelbeckMaria Apfelbeck More articles by this author , Markus GrabbertMarkus Grabbert More articles by this author , Christian G. StiefChristian G. Stief More articles by this author , and Alexander KarlAlexander Karl More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.931AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Since the 1980's, urinary diversion via orthotopic neobladder (NB) is considered to be the treatment of choice in physically, mentally and emotionally suitable patients, offering the ideal combination of a low-pressure and simultaneously continent system. There is still a lack of data concerning quality of life (QoL) after radical cystectomy and urinary diversion via NB. The following study adds important knowledge in a large patient cohort analyzing QoL and including both functional as well as oncological aspects. METHODS Postoperative quality of life of 152 patients (n = 133 male, n = 19 female) after radical cystectomy and urinary diversion via NB in one tertiary care center was assessed retrospectively using the QoL score (global health status) taking account of current EORTC instructions. Potential influence factors of patient's quality of life including sex, time of follow-up, pT-stage, pN-stage, continence, and sexual function were evaluated. Continence was determined using ICIQ scoring system and pad usage. Depending on the respective ICIQ score, patient's stress urinary incontinence was classified as mild (1–5), moderate (6–10) and severe (>10). Sexual function was assessed using IIEF and FSFI6 score. To analyze QoL in the respective subgroups, Mann-Whitney-U-, Kruskal-Wallis-ANOVA and post hoc-testing was used. A p-value below 0.05 was considered statistically significant. RESULTS Median follow-up was 48 months (3–108) with 12.5% of the patient collective being female and 87.5% being male. Overall QoL score was 75 for male patients and 67 for female patients (p = 0.019). Timing of respective follow-up had no significant influence on QoL score (p=0.064). Regarding potential oncological influencing factors we found no statistical influence for lymph node involvement as well as pT-stage (p=0.760, p=0.632 respectively). Analysis of sexual outcome revealed a significant influence of IIEF score [<20 (median QoL 75) vs. >20 (median QoL 83), p=0.045]. We found a significant impact of severity of incontinence based on ICIQ score [mild-to-moderate (median QoL 83) vs. severe (median QoL 67), p<0.001] as well as daily pad usage [0-1 pad (median QoL 83) vs. >2 pads (median QoL 65), p<0.001]. CONCLUSIONS While continence and male sexual function are strong predictors for a satisfying QoL, histopathological parameters like lymph node involvement and T-stage are not shown to have a significant impact on patient's QoL. Providing results of a large monocentric patient cohort, our results indicate the major role that functional outcomes after urinary diversion via NB play for the individual patient. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e196 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alexander Kretschmer More articles by this author Tobias Grimm More articles by this author Alexander Buchner More articles by this author Birte-Swantje Schneevoigt More articles by this author Maria Apfelbeck More articles by this author Markus Grabbert More articles by this author Christian G. Stief More articles by this author Alexander Karl More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...